Pazopanib (Votrient®)

Pazopanib is a targeted therapy drug used to treat a type of kidney cancer called renal cell carcinoma. It can also treat some soft tissue sarcomas.

Pazopanib is given as tablets. You usually have it as an outpatient. Your cancer doctor or nurse will tell you how often you will have it.

Like all targeted therapy drugs, pazopanib can cause side effects. Some side effects can be serious, so it’s important to read the detailed information below. How targeted therapy affects people varies from person to person. It’s important to read about the side effects so that you know what to expect. Your healthcare team can talk to you more about this and give you advice on how to manage any side effects.

Tell your doctor or nurse straight away if you:

  • have a temperature
  • feel unwell
  • have severe side effects, including any we don’t mention here.

Rarely, side effects may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

If you need to seek medical attention for any reason other than cancer, always tell the healthcare staff that you are having this treatment.

How pazopanib works

Pazopanib is a type of treatment called a tyrosine kinase inhibitor (TKI), also known as a cancer growth inhibitor. Kinases are important proteins in the body that regulate how the cells grow and divide. Pazopanib blocks the proteins (kinases) from sending signals to cancer cells to grow. Blocking the signals causes the cells to die.

Pazopanib can also stop the cancer cells from developing new blood vessels. This reduces their supply of oxygen and nutrients, so that the tumour shrinks or stops growing. This is known as anti-angiogenesis treatment.

It’s best to read this information with our general information about the type of cancer you have. During treatment, you will see a cancer doctor and a cancer nurse. This is who we mean when we mention doctor or nurse in this information.

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos


When pazopanib is given

Pazopanib may only be available in some situations. Your cancer doctor can tell you if it is appropriate for you. Some people may be given pazopanib as part of a clinical trial. If a drug is not available on the NHS, there may be different ways you can still have it. Your cancer doctor can give you advice.

Kidney cancer

Pazopanib can be used to treat people with kidney cancer that has spread outside the kidney (advanced renal cell cancer). It can be used:

Soft tissue sarcoma

Pazopanib may be given for certain types of soft tissue sarcoma when the cancer has spread to another part of the body (metastatic cancer) and chemotherapy treatment has already been used.


Taking pazopanib

You take pazopanib as a tablet once a day. Take the tablets with a glass of water, one hour before you eat or two hours after you eat. If you take pazopanib at the same time as you eat, it can affect how it works. Don’t chew or crush the tablets before you take them as this may increase side effects. Avoid grapefruit and grapefruit juice during your treatment as it may increase side effects.

Always take your tablets exactly as your nurse or pharmacist explained. This is important to make sure they work as well as possible for you.

There are some important things to remember when taking your tablets:

  • If you forget to take your tablets or are sick after taking them, just take your next dose at the usual time – don’t take a double dose.
  • Keep the tablets in the original packaging and at room temperature, away from heat and direct sunlight.
  • Keep the tablets in a safe place, out of the reach of children.
  • Get a new prescription before you run out of tablets and make sure you have plenty for the holidays.
  • If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Don’t flush them down the toilet or throw them away.


Possible side effects of pazopanib

Each person’s reaction to cancer treatment is different. Some people have very few side effects, while others may experience more. The side effects described here won’t affect everyone having this treatment.

We explain the most common side effects but have not included all the less common ones as they are unlikely to affect you. If you have any side effects that we don’t mention, tell your doctor or specialist nurse.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.

High blood pressure

Pazopanib can cause high blood pressure in some people. You should let your doctor know if you already have high blood pressure before starting this treatment.

Your blood pressure will be checked regularly for the first six weeks of treatment. If your blood pressure goes up, it is most likely to happen in the first few weeks of taking the drug. If you develop high blood pressure, you will be prescribed medicines to help control it.

Diarrhoea

If you have diarrhoea, contact the hospital for advice. Try to drink at least two litres (three and a half pints) of fluids every day. It can help to avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods.

If diarrhoea is severe or continues, tell your doctor.

Effects on the hair

Your hair may lose colour and it may become thinner while you are taking pazopanib. Changes to your hair are usually temporary and get better if you stop treatment. But for some people, hair changes can be permanent.

Feeling sick

Your doctor can give you anti-sickness drugs to help prevent or control sickness. If you still feel sick, tell your doctor. They can prescribe other anti-sickness drugs that may work better for you.

Sore mouth

You may get a sore mouth or mouth ulcers. This can make you more likely to get a mouth infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth is sore:

  • tell your nurse or doctor – they can give you a mouthwash or medicines to help
  • try to drink plenty of fluids
  • avoid alcohol, tobacco, and foods that irritate your mouth.

Changes to your taste

You may get a bitter or metal taste in your mouth. Sucking sugar-free sweets may help with this. Some foods may taste bad or have no taste. Try different foods to find out what tastes best to you. Taste changes usually get better after treatment finishes. Your nurse can give you more advice.

Loss of appetite

This treatment can affect your appetite. Don’t worry if you don’t eat much for a day or two after treatment. But if your appetite does not come back after a few days, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.

Feeling tired

Feeling tired is a common side effect. It is often worse towards the end of treatment and for some weeks after it has finished. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

Effects on the skin

You may develop a rash and your skin may feel dry and itchy or peel. Some people notice their skin loses some of its colour. Tell your doctor or specialist nurse if you notice any skin changes. They can advise you about creams or lotions to help with dryness and can prescribe medicines to relieve itching.

Hand and foot skin reaction

The palms of your hands and soles of your feet may get red, sore or swollen. You may also notice numbness or tingling in them. If this happens, moisturise your hands and feet with an unperfumed moisturiser, keep them cool and avoid hot water.

If soreness doesn’t settle or if blistering develops, your doctor may need to reduce the dose of pazopanib or interrupt the treatment. Very occasionally, people may need to stop having the treatment completely.

Tummy pain

Some people have pain or discomfort in their tummy when taking pazopanib. Let your doctor know if this happens to you.

Very rarely, pazopanib can cause a hole (perforation) in the small bowel. Contact your doctor immediately if you have severe pain in the tummy and sickness and vomiting. It’s also very important to let them know if you have bleeding from the back passage, black stools, vomiting up blood or vomit that looks like coffee grounds.

Headaches

This treatment may cause headaches. If this happens, tell your doctor or nurse. They can give you painkillers.

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.

If you have an infection, it is important to treat it as soon as possible. Contact the hospital straight away on the 24-hour contact number you have if:

  • your temperature goes over 37.5°C (99.5°F)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection.

Symptoms of an infection include:

  • feeling shaky
  • a sore throat
  • a cough
  • diarrhoea
  • needing to pass urine a lot.

It is important to follow any specific advice your cancer treatment team gives you.

The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time.

Bruising and bleeding

Pazopanib can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding that you can’t explain. This includes:

  • nosebleeds
  • bleeding gums
  • tiny red or purple spots on the skin that may look like a rash.

Some people may need a drip to give them extra platelets. This is called a platelet transfusion. Sometimes your doctor may ask you to stop taking pazopanib or reduce the dose for a time to help.

Dizziness

You may have some mild dizziness. Tell your doctor if you notice this. It may affect your ability to drive.

Muscle and/or joint pain

You may get pain in your joints or muscles. Tell your doctor if this happens so they can give you painkillers. Let them know if the pain does not get better. Having warm baths and taking regular rests may help.

Effects on the lungs

This treatment can cause changes to the lungs. Tell your doctor if you develop:

  • a cough
  • wheezing
  • a fever (high temperature)
  • breathlessness.

You should also tell them if any existing breathing problems get worse. You may have tests to check your lungs.

Hot flushes

Occasionally people have hot flushes while taking this treatment. If you are affected tell your doctor or specialist nurse, who can give you advice on coping with them.

Slow wound-healing

Wounds often take longer to heal while you're having treatment with pazopanib. If you need an operation, your doctor will tell you to stop taking pazopanib before it and for a few weeks afterwards. You may also need to stop taking pazopanib for a few days if you are having dental treatment. Talk to your doctor if you need to have surgery or dental treatment.

Watch our hair loss video playlist

In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.

Watch our hair loss video playlist

In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.


Less common side effects

Effects on the heart

In a small number of people, pazopanib can affect the heart. Tell your doctor if you have a heart condition or high blood pressure before starting treatment.

Contact a doctor straight away if you:

  • have pain or tightness in your chest
  • feel breathless or dizzy
  • feel your heart is beating too fast or too slowly.

Other conditions can cause these symptoms, but it is important to get them checked by a doctor.

Stroke

Pazopanib can increase the risk of having a stroke. Signs of a stroke include:

  • weakness or numbness in one or both of your arms
  • slurred speech
  • drooping of your face, mouth or eye.

If you or someone you know notices you have any of these symptoms, you should tell a doctor immediately.

Confusion and seizures (fits)

Rarely, pazopanib can cause the brain to swell. This can cause confusion, seizures or sudden loss of vision. Contact your doctor immediately if you experience any of these symptoms.

Blurred vision

You may notice your vision becomes blurred. Rarely, this can be a sign of an eye problem which needs urgent medical treatment. Contact your doctor straightaway if your vision becomes blurred.

Effects on the thyroid gland

This treatment can sometimes affect the thyroid gland, making it less active. Your doctor will check how your thyroid is working with regular blood tests. If this happens, it can be easily treated with medication and goes back to normal after the treatment is finished.

Effects on the liver

Pazopanib may cause changes in the way your liver works. This doesn’t generally cause any symptoms and usually goes back to normal when treatment stops. Your doctor will monitor your liver with regular blood tests.

It’s important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they’re not mentioned above.


Other information

Other drugs

Some medicines, including ones you buy in a shop or chemist, can be harmful while you are having this treatment. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.

Contraception

Your doctor will advise you not to get pregnant or father a child while having this treatment and for some time afterwards. The drugs may harm the developing baby. It is important to use effective contraception.

Breastfeeding

Women are advised not to breastfeed while having this treatment and for some time afterwards. This is because the drugs could be passed to the baby through breast milk.

Fertility

Doctors don’t yet know how this treatment may affect your fertility (the ability to become pregnant or father a child). If you are worried about this, talk to you doctor before treatment starts.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having this treatment.